Provider Demographics
NPI:1326261272
Name:HERSEY, DANIEL L (EDD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:HERSEY
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 E BAKER ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-3700
Mailing Address - Country:US
Mailing Address - Phone:813-719-1776
Mailing Address - Fax:813-754-2496
Practice Address - Street 1:1001 E BAKER ST
Practice Address - Street 2:SUITE 300
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-3700
Practice Address - Country:US
Practice Address - Phone:813-719-1776
Practice Address - Fax:813-754-2496
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT0000347106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist